The hypothesis that TNF-α may play a role in VS-induced SNHL comes from several studies showing that (a) VS tumor secretions contain high levels of TNF-α (20), (b) VS tumor size and proximity to the inner ear are poorly correlated with SNHL in VS patients (3), and (c) upregulation of TNF-α in the cochlea in response to a variety of etiologies of inner ear disease causes hearing loss (21–25, 42–46). Here, TNF is linked to inner ear disorder.